<div
  id="_page"
  style="
    margin: 0px auto;
    background: rgb(255, 255, 255);
    width: 210mm;
    min-height: 297mm;
    transform: scale(1, 1);
    transform-origin: 50% 0px 0px;
  "
  pagekind="A4"
  direct="portrait"
>
  <div
    id="_header"
    style="
      min-height: 0.65cm;
      padding-left: 0.65cm;
      padding-right: 0.65cm;
      padding-top: 0.65cm;
      position: relative;
      outline: none;
    "
    contenteditable="false"
    class=""
  >
    <div style="text-align: center">&nbsp;</div>
    <div style="text-align: center; font-size: 15px">
      <span>姓名：</span>
      <field
        tabindex="0"
        id="name"
        type="Text"
        contenteditable="true"
        class="input blank"
        title="姓名"
        value="姓名"
        name="name"
        data-code=""
        data-expression=""
        multiline="false"
        validate="false"
        format=""
        style="display: inline-block; min-width: 60px"
        >姓名</field
      >
      <span>&nbsp;科室：</span>
      <field
        tabindex="0"
        id="department"
        type="Text"
        contenteditable="true"
        class="input blank"
        title="科室"
        value="科室"
        name="department"
        data-code=""
        data-expression=""
        multiline="false"
        validate="false"
        format=""
        style="display: inline-block; min-width: 60px"
        >科室</field
      ><span>&nbsp;床号：</span>
      <field
        tabindex="0"
        id="bed_number"
        type="Text"
        contenteditable="true"
        class="input blank"
        title="床号"
        value="床号"
        name="bed_number"
        data-code=""
        data-expression=""
        multiline="false"
        validate="false"
        format=""
        style="display: inline-block; min-width: 60px"
        >床号</field
      ><span title="" contenteditable="false">&nbsp;住院号：</span>
      <field
        tabindex="0"
        id="admission_number"
        type="Text"
        contenteditable="true"
        class="input blank"
        title="住院号"
        value="文本输入域"
        name="admission_number"
        data-code=""
        data-expression=""
        multiline="false"
        validate="false"
        format=""
        style="display: inline-block; min-width: 60px"
        >住院号</field
      ><span>&nbsp;病案号：</span>
      <field
        tabindex="0"
        id="medical_record_number"
        type="Text"
        contenteditable="true"
        class="input blank"
        title="病案号"
        value="文本输入域"
        name="medical_record_number"
        data-code=""
        data-expression=""
        multiline="false"
        validate="false"
        format=""
        style="display: inline-block; min-width: 60px"
        >病案号</field
      >&nbsp;
    </div>
  </div>
  <div
    id="_body"
    style="min-height: calc(1024.25px); padding-left: 0.65cm; padding-right: 0.65cm"
    contenteditable="false"
    class=""
  >
    <div class="Section0" style="">
      <p class="MsoNormal" style="margin-top: 10.25pt; margin-left: 213.2pt; mso-outline-level: 1">
        <span style="letter-spacing: 0.9pt; font-weight: bold; font-size: 16pt">抑郁焦虑表</span>
      </p>
      <table class="16" id="" title="" data-field="" style="border-width: 1px; border-color: rgb(0, 0, 0)">
        <colgroup>
          <col style="width: 421px" />
          <col style="width: 304px" />
        </colgroup>
        <tbody style="">
          <tr style="height: 72.8pt">
            <td colspan="2" class="">
              <p class="15" style="margin-top: 1pt; margin-left: 26.1pt; line-height: 1.5">
                <span style="letter-spacing: 0.266667px; font-size: 10.5pt">1）我对以往感兴趣的事情还是有兴趣</span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <group type="radio" id="radio0" style="font-size: 10.5pt"
                  ><input type="radio" id="radio0__0" name="radio0" value="0" checked="true" /><label for="radio0__0"
                    >肯定一样——0分</label
                  ><br /><input type="radio" id="radio0__1" name="radio0" value="1" style="" /><label for="radio0__1"
                    >不像以前那样——1分</label
                  ><br /><input type="radio" id="radio0__2" name="radio0" value="2" /><label for="radio0__2"
                    >只有一点——2分</label
                  ><br /><input type="radio" id="radio0__3" name="radio0" value="3" /><label for="radio0__3"
                    >基本上没有了——3分</label
                  ><br /></group
                ><br />
              </p>
            </td>
          </tr>
          <tr style="height: 72.5pt">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p
                class="15"
                style="margin-top: 1.55pt; margin-left: 25.5pt; line-height: 15.65pt; mso-line-height-rule: exactly"
              >
                <span style="font-size: 12px; letter-spacing: 0.333333px">2</span
                ><span style="letter-spacing: 0.333333px; font-size: 10.5pt">）我能够哈哈大笑，并看到事物好的一面</span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <group type="radio" id="radio1" style="font-size: 10.5pt"
                  ><input type="radio" id="radio1__0" name="radio1" value="0" checked="true" /><label for="radio1__0"
                    >我经常这样——0分</label
                  ><br /><input type="radio" id="radio1__1" name="radio1" value="1" /><label for="radio1__1"
                    >现在已经不太这样了——1分</label
                  ><br /><input type="radio" id="radio1__2" name="radio1" value="2" /><label for="radio1__2"
                    >现在肯定是不太多了——2分</label
                  ><br /><input type="radio" id="radio1__3" name="radio1" value="3" /><label for="radio1__3"
                    >根本没有——3分</label
                  ><br /></group
                ><br />
              </p>
            </td>
          </tr>
          <tr style="height: 72.55pt">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p class="15" style="margin-top: 2.25pt; margin-left: 25.6pt">
                <span style="letter-spacing: 0.15pt; font-size: 9pt">3</span
                ><span style="letter-spacing: 0.15pt; font-size: 10.5pt">）我感到愉快</span>
              </p>
              <p class="15" style="margin-top: 5.2pt; margin-left: 24.75pt; line-height: 15.7pt">
                <span style="letter-spacing: -0.65pt; position: relative; top: -5pt"
                  ><group type="radio" id="radio2" style="font-size: 10.5pt"
                    ><input type="radio" id="radio2__0" name="radio2" value="0" checked="true" /><label for="radio2__0"
                      >大多数时间——0分</label
                    ><br /><input type="radio" id="radio2__1" name="radio2" value="1" /><label for="radio2__1"
                      >有时——1分</label
                    ><br /><input type="radio" id="radio2__2" name="radio2" value="2" /><label for="radio2__2"
                      >并不经常——2分</label
                    ><br /><input type="radio" id="radio2__3" name="radio2" value="3" /><label for="radio2__3"
                      >根本没有——3分</label
                    ><br /></group
                  ><br
                /></span>
              </p>
            </td>
          </tr>
          <tr style="height: 72.55pt">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p class="15" style="margin-top: 3.1pt; margin-left: 25.35pt; line-height: 1.5">
                <span style="letter-spacing: 0.25pt; font-size: 9pt">4</span
                ><span style="font-size: 10.5pt; line-height: 1.5"
                  ><span style="letter-spacing: 0.25pt">）我对自己的仪容失去兴趣</span><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-top: 5.2pt; margin-left: 24.75pt; line-height: 1.5">
                <span style="letter-spacing: -0.85pt; position: relative; top: -5pt; line-height: 1.5"
                  ><group type="radio" id="radio3" style="font-size: 10.5pt; line-height: 1.5"
                    ><input type="radio" id="radio30" name="radio3" value="0" checked="true" /><label for="radio30"
                      >我仍然像以往一样关心——0分</label
                    ><br /><input type="radio" id="radio31" name="radio3" value="1" /><label for="radio31"
                      >我可能不是非常关心——1分</label
                    ><br /><input type="radio" id="radio32" name="radio3" value="2" /><label for="radio32"
                      >并不像我应该做的那样关心我——2分</label
                    ><br /><input type="radio" id="radio33" name="radio3" value="3" /><label for="radio33"
                      >肯定——3分</label
                    ><br /></group
                  ><span style="font-size: 10.5pt; line-height: 1.5"><br /></span
                ></span>
              </p>
            </td>
          </tr>
          <tr style="height: 72.55pt">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p class="15" style="margin-top: 3.8pt; margin-left: 25.6pt; line-height: 1.5">
                <span style="font-size: 10.5pt; line-height: 1.5"
                  ><span style="letter-spacing: 0.2pt; position: relative; top: -5pt">5）我对一切都是乐观地向前看</span
                  ><o:p style=""></o:p
                ></span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <span style="letter-spacing: -0.45pt"
                  ><group type="radio" id="radio4" style="font-size: 10.5pt"
                    ><input type="radio" id="radio40" name="radio4" value="0" checked="true" /><label for="radio40"
                      >差不多是这样做——0分</label
                    ><br /><input type="radio" id="radio41" name="radio4" value="1" /><label for="radio41"
                      >并不完全是这样做的——1分</label
                    ><br /><input type="radio" id="radio42" name="radio4" value="2" /><label for="radio42"
                      >很少这样做——2分</label
                    ><br /><input type="radio" id="radio43" name="radio4" value="3" /><label for="radio43"
                      >几乎从不这样做——3分</label
                    ><br /></group
                  ><br
                /></span>
              </p>
            </td>
          </tr>
          <tr style="height: 108px">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p
                class="15"
                style="margin-top: 4.5pt; margin-left: 25.5pt; line-height: 15.75pt; mso-line-height-rule: exactly"
              >
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.25pt; position: relative; top: -5pt">6）我好像感到情绪在渐渐低落</span
                  ><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <span style="letter-spacing: -0.75pt"
                  ><group type="radio" id="radio5" style="font-size: 10.5pt"
                    ><input type="radio" id="radio5__0" name="radio5" value="0" checked="true" /><label for="radio5__0"
                      >根本没有——0分</label
                    ><br /><input type="radio" id="radio5__1" name="radio5" value="1" /><label for="radio5__1"
                      >有时——1分</label
                    ><br /><input type="radio" id="radio5__2" name="radio5" value="2" /><label for="radio5__2"
                      >很经常——2分</label
                    ><br /><input type="radio" id="radio5__3" name="radio5" value="3" /><label for="radio5__3"
                      >几乎所有时间——3分</label
                    ><br /></group
                  ><br
                /></span>
              </p>
            </td>
          </tr>
          <tr style="height: 118px">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p class="15" style="margin-top: 3.25pt; margin-left: 25.5pt">
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.25pt">7)我能欣赏一本好书或意向好的广播或电视节目</span><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-top: 5.25pt; margin-left: 24.75pt; line-height: 15.7pt">
                <group type="radio" id="radio6" style="font-size: 10.5pt"
                  ><input type="radio" id="radio6__0" name="radio6" value="0" /><label for="radio6__0"
                    >常常如此——0分</label
                  ><br /><input type="radio" id="radio6__1" name="radio6" value="1" checked="true" /><label
                    for="radio6__1"
                    >有时——1分</label
                  ><br /><input type="radio" id="radio6__2" name="radio6" value="2" /><label for="radio6__2"
                    >并非经常——2分</label
                  ><br /><input type="radio" id="radio6__3" name="radio6" value="3" /><label for="radio6__3"
                    >很少——3分</label
                  ><br /></group
                ><br />
              </p>
            </td>
          </tr>
          <tr style="height: 38px">
            <td class="" style="border-color: rgb(0, 0, 0)">
              <p class="15" style="margin-top: 9.5pt; margin-left: 25.4pt">
                <span style="letter-spacing: 0.1pt; font-size: 10.5pt"
                  ><font face="宋体" style="">抑郁得分（</font>0-21分）</span
                ><span style="font-size: 9pt"><o:p></o:p></span>
              </p>
            </td>
            <td class="">
              <p class="MsoNormal" style="">
                <span style="font-family: Arial; font-size: 10.5pt"
                  ><span>&nbsp;</span
                  ><field
                    tabindex="0"
                    id="total1"
                    type="Text"
                    contenteditable="true"
                    class="input"
                    title="文本输入域"
                    value="1"
                    name="total1"
                    data-code=""
                    data-expression="=  radio0 + radio1 + radio2 + radio3 + radio4 + radio5 + radio6"
                    multiline="false"
                    validate="false"
                    format=""
                    style="display: inline-block; min-width: 100px; text-align: left"
                    >1</field
                  >&nbsp;</span
                >
              </p>
            </td>
          </tr>

          <tr style="height: 72.55pt">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p class="15" style="margin-top: 1.75pt; margin-left: 26.1pt">
                <span style="letter-spacing: 0.1pt; font-size: 10.5pt">1）我感到紧张（或痛苦）</span>
              </p>
              <p class="15" style="margin-top: 5.2pt; margin-left: 24.75pt; line-height: 15.7pt">
                <span style="font-size: 10.5pt"
                  ><group type="radio" id="radio7" style=""
                    ><input type="radio" id="radio7__0" name="radio7" value="0" checked="true" /><label for="radio7__0"
                      >根本没有——0分</label
                    ><br /><input type="radio" id="radio7__1" name="radio7" value="1" /><label for="radio7__1"
                      >有时候——1分</label
                    ><br /><input type="radio" id="radio7__2" name="radio7" value="2" /><label for="radio7__2"
                      >大多时候——2分</label
                    ><br /><input type="radio" id="radio7__3" name="radio7" value="3" /><label for="radio7__3"
                      >几乎所有时候——3分</label
                    ><br /></group
                  ><span>&nbsp;</span></span
                >
              </p>
            </td>
          </tr>
          <tr style="height: 138px">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p
                class="15"
                style="margin-top: 2.5pt; margin-left: 25.5pt; line-height: 15.7pt; mso-line-height-rule: exactly"
              >
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.25pt; position: relative; top: -5pt"
                    >2）我感到有点害怕好像预感到什么可怕的事情要发生</span
                  ><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <group type="radio" id="radio8" style="font-size: 10.5pt"
                  ><input type="radio" id="radio8__0" name="radio8" value="0" checked="true" /><label for="radio8__0"
                    >根本没有——0分</label
                  ><br /><input type="radio" id="radio8__1" name="radio8" value="1" /><label for="radio8__1"
                    >有一点，但并不使我苦恼——1分</label
                  ><br /><input type="radio" id="radio8__2" name="radio8" value="2" /><label for="radio8__2"
                    >是有，不太严重——2分</label
                  ><br /><input type="radio" id="radio8__3" name="radio8" value="3" /><label for="radio8__3"
                    >非常肯定和十分严重——3分</label
                  ><br /></group
                ><br />
              </p>
            </td>
          </tr>
          <tr style="height: 127px">
            <td colspan="2" class="" style="border-color: rgb(0, 0, 0)">
              <p class="MsoNormal" style="text-indent: 30px">
                <span style="font-size: 10.5pt">3）我的心中充满烦恼</span>
              </p>
              <p class="MsoNormal" style="margin-left: 24.75pt">
                <span style="font-size: 10.5pt"
                  ><group type="radio" id="radio9" style=""
                    ><input type="radio" id="radio90" name="radio9" value="0" checked="true" /><label for="radio90"
                      >根本没有——0分</label
                    ><br /><input type="radio" id="radio91" name="radio9" value="1" style="" /><label for="radio91"
                      >有时候——1分</label
                    ><br /><input type="radio" id="radio92" name="radio9" value="2" /><label for="radio92"
                      >大多时候——2分</label
                    ><br /><input type="radio" id="radio93" name="radio9" value="3" /><label for="radio93"
                      >几乎所有时候——3分</label
                    ><br /></group
                ></span>
              </p>
            </td>
          </tr>
          <tr class="" style="">
            <td colspan="2">
              <!--StartFragment-->
              <p
                class="15"
                style="margin-top: 1.9pt; margin-left: 25.35pt; line-height: 15.65pt; mso-line-height-rule: exactly"
              >
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.25pt; position: relative; top: -5pt">4）我能够安闲而轻松地坐着</span
                  ><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <group type="radio" id="radio10" style=""
                  ><input type="radio" id="radio100" name="radio10" value="0" checked="true" /><label for="radio100"
                    >肯定--0分</label
                  ><br /><input type="radio" id="radio101" name="radio10" value="1" /><label for="radio101"
                    >经常--1分</label
                  ><br /><input type="radio" id="radio102" name="radio10" value="2" /><label for="radio102"
                    >并不经常--2分</label
                  ><br /><input type="radio" id="radio103" name="radio10" value="3" /><label for="radio103"
                    >更本没有--3分</label
                  ><br
                /></group>
              </p>
              <!--EndFragment-->
            </td>
          </tr>
          <tr class="" style="">
            <td colspan="2" style="">
              <!--StartFragment-->
              <p class="15" style="margin-top: 2.95pt; margin-left: 25.6pt">
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.25pt">5）我有点坐立不安，好像感到非要活动不可</span><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-top: 5.2pt; margin-left: 24.75pt; line-height: 15.75pt">
                <group type="radio" id="radio11" style=""
                  ><input type="radio" id="radio11__0" name="radio11" value="0" checked="true" /><label for="radio11__0"
                    >根本没有——0分</label
                  ><br /><input type="radio" id="radio11__1" name="radio11" value="1" /><label for="radio11__1"
                    >并不很少——1分</label
                  ><br /><input type="radio" id="radio11__2" name="radio11" value="2" /><label for="radio11__2"
                    >是不少——2分</label
                  ><br /><input type="radio" id="radio11__3" name="radio11" value="3" /><label for="radio11__3"
                    >确实非常多——3分</label
                  ><br
                /></group>
              </p>
              <!--EndFragment-->
            </td>
          </tr>
          <tr class="">
            <td colspan="2" style="">
              <span> </span
              ><!--StartFragment-->
              <p class="15" style="margin-top: 3.95pt; margin-left: 25.5pt">
                <span style="letter-spacing: 0.2pt; font-size: 9pt">6）</span
                ><span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.2pt">我突然发现有恐慌感</span><o:p></o:p
                ></span>
              </p>
              <p
                class="15"
                style="margin-top: 5.2pt; margin-left: 24.75pt; line-height: 15.75pt; mso-line-height-rule: exactly"
              >
                <group type="radio" id="radio12" style=""
                  ><input type="radio" id="radio12__0" name="radio12" value="0" checked="true" /><label for="radio12__0"
                    >根本没有——0分</label
                  ><br /><input type="radio" id="radio12__1" name="radio12" value="1" /><label for="radio12__1"
                    >并非经常——1分</label
                  ><br /><input type="radio" id="radio12__2" name="radio12" value="2" /><label for="radio12__2"
                    >非常肯定，十分严重——2分</label
                  ><br /><input type="radio" id="radio12__3" name="radio12" value="3" /><label for="radio12__3"
                    >确实很经常——3分</label
                  ><br
                /></group>
              </p>
              <!--EndFragment--><span
              > </span>
            </td>
          </tr>
          <tr class="" style="">
            <td colspan="2" style="">
              <span> </span
              ><!--StartFragment-->
              <p
                class="15"
                style="margin-top: 2.95pt; margin-left: 25.65pt; line-height: 15.75pt; mso-line-height-rule: exactly"
              >
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.25pt; position: relative; top: -5pt"
                    >7）我感到有点害怕，好像某个内脏器官变化了</span
                  ><o:p></o:p
                ></span>
              </p>
              <p class="15" style="margin-left: 24.75pt">
                <group type="radio" id="radio13" style=""
                  ><input type="radio" id="radio13__0" name="radio13" value="0" checked="true" /><label for="radio13__0"
                    >根本没有——0分</label
                  ><br /><input type="radio" id="radio13__1" name="radio13" value="1" /><label for="radio13__1"
                    >有时——1分</label
                  ><br /><input type="radio" id="radio13__2" name="radio13" value="2" /><label for="radio13__2"
                    >很经常——2分</label
                  ><br /><input type="radio" id="radio13__3" name="radio13" value="3" /><label for="radio13__3"
                    >非常经常——3分</label
                  ><br
                /></group>
              </p>
              <!--EndFragment--><span
              > </span>
            </td>
          </tr>
          <tr style="height: 35px">
            <td
              class=""
              id=""
              title=""
              style="
                border-color: rgb(0, 0, 0);
                background-color: rgb(255, 255, 255);
                vertical-align: middle;
                text-align: center;
              "
            >
              <p class="15" style="text-align: center; margin-top: 0pt; margin-left: 0pt">
                <span style="letter-spacing: 0.1pt; font-size: 10.5pt"
                  ><font face="宋体" style=""></font>

                  <!--StartFragment-->焦虑得分</span
                >
              </p>
            </td>
            <td class="" style="border-width: 1pt; border-color: rgb(0, 0, 0)">
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                tabindex="0"
                id="total2"
                name="total2"
                type="Text"
                contenteditable="true"
                class="input"
                title="文本输入域"
                value="0"
                data-code=""
                data-expression="= radio7 + radio8 + radio9 + radio10 + radio11 + radio12 +  radio13"
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                validate="false"
                format=""
                style="display: inline-block; min-width: 100px; text-align: left"
                >0</field
              ><span>&nbsp;</span>
            </td>
          </tr>
          <tr class="">
            <td colspan="1">
              <span> </span
              ><!--StartFragment-->
              <p class="15" style="margin-top: 1.75pt; margin-left: 129.05pt">
                <span style="font-size: 10.5pt"><span>结果</span><o:p></o:p></span>
              </p>
              <p
                class="15"
                style="margin-top: 0.05pt; margin-right: 0.65pt; margin-left: 124.2pt; text-indent: -97.25pt"
              >
                <span style="font-size: 10.5pt"
                  ><span style="letter-spacing: 0.2pt"><font face="宋体">（</font>0-7分为阴性;8-10为轻度;11-14分为</span
                  ><span style="letter-spacing: 0.15pt"><font face="宋体">中度</font>;15-21分为</span>&nbsp;<span
                    style="letter-spacing: -0.1pt"
                    >重</span
                  ><span style="letter-spacing: -0.1pt">度）</span></span
                >
              </p>
              <!--EndFragment--><span
              > </span>
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                tabindex="0"
                id="field_4"
                name="field_4"
                type="Text"
                contenteditable="true"
                class="input"
                title="文本输入域"
                value="1"
                data-code=""
                data-expression="=total1 + total2"
                multiline="false"
                validate="false"
                format=""
                style="display: inline-block; min-width: 100px; text-align: left"
                >1</field
              >&nbsp;<br />
            </td>
          </tr>
        </tbody>
      </table>
    </div>
    <p class="MsoNormal" style="margin-left: 90.05pt">
      <span
        style="position: absolute; z-index: 1; margin-left: 75.5px; margin-top: 112.3333px; width: 680px; height: 0px"
        ><br /></span
      ><span
        style="position: absolute; z-index: 1; margin-left: 75.5px; margin-top: 112.3333px; width: 680px; height: 0px"
        ><br /></span
      ><span
        style="position: absolute; z-index: 1; margin-left: 75.5px; margin-top: 112.3333px; width: 680px; height: 0px"
        ><br
      /></span>
    </p>
    <br />
  </div>
  <div
    id="_footer"
    style="
      position: relative;
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      padding-left: 0.65cm;
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    contenteditable="false"
    class=""
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